Patient diagnosis using triage protocols that have customized messages at exit points

ABSTRACT

A decison flowchart of a triage protocol is provided for a medical condition of a patient. The flowchart includes a plurality of decision blocks. Each decision block relates to one or more patient symptoms and/or considerations. A plurality of exit points are provided in the flowchart. Each exit point is associated with a respective decision block. Each exit point is reached upon the presence or absence of a symptom or consideration in the respective decision block. Each exit point recommends an action to be taken by the patient. The exit points may be customized. More specifically, the recommended action at selected exit points may be individually selected from a plurality of selectable actions. Thus, the decision flowchart may provide different recommended courses of action for a patient having the same symptoms and/or considerations based upon individual selections. The recommended action becomes an exit message for the respective exit point.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. ProvisionalApplication No. 60/195,001 filed Apr. 5, 2000 entitled “SYSTEM ANDMETHOD FOR AN ONLINE INTEGRATED PROFESSIONAL SERVICE ENVIRONMENT.”

BACKGROUND OF THE INVENTION

[0002] Triage is a process for sorting injured or ill people into groupsbased on their need for or likely benefit from immediate medicaltreatment. Triage is used on the battlefield, at disaster sites, and inhospital emergency rooms when limited medical resources must beallocated.

[0003] Triage protocols (sometimes referred to as “symptom charts”) havebeen created to assist medical providers and patients in determiningwhat medical treatment, if any, should be received given a set ofmedical conditions. For example, a triage protocol for dehydration in ayoung pediatric patient (e.g., birth-6 yrs.) may consist of a listing ofsymptoms and considerations that correspond with different levels ofconcern. If the symptom listing and considerations indicate that thepatient has emergent symptoms (i.e., symptoms that demand immediateaction), then the triage protocol may indicate that the patient shouldseek immediate treatment (e.g., 0-60 minutes). If the symptom listingand considerations indicate that the patient has urgent symptoms, thenthe triage protocol may indicate that the patient should seek treatmentor be seen by a medical provider for further diagnosis within 1-8 hours.If the symptom listing and considerations indicate that the patient hasacute symptoms, then the triage protocol may indicate that the patientshould seek treatment or be seen by a medical provider for furtherdiagnosis within 8-24 hours.

[0004] Triage protocols or symptom charts are typically arranged inchart format. However, the triage protocol may be configured to appearin a flowchart format for easier use by the medical provider or thepatient. Examples of flowchart-type symptom charts for over 100different potential medical conditions are illustrated in the HarvardMedical School Family Health Guide, published by Simon & Schuster,Copyright (D 1999 by President and Fellows of Harvard College (AnthonyL. Komaroff, MD, Editor in Chief).

[0005] Triage protocols are widely used by medical facilities inresponding to telephone calls from patients. This service is referred toas teletriage. Teletriage is often provided by call center servicesstaffed by specially trained registered nurses (RN's) or doctors who canprovide reliable information to individuals with questions or concernsabout a medical situation. A medical plan may offer teletriage as a planbenefit.

[0006] The medical industry is slowly adopting automated tools fordelivering medical services to patients. U.S. Pat. No. 5,594,638 (Iliff)describes a computerized medical diagnostic and treatment advice systemthat operates over a telephone network. In one feature of the system, apatient uses an automated telephone system to answer a series ofscreening questions related to their medical condition. After thescreening questions are completed, the system software determines if thepatient has a serious medical condition that requires immediateintervention. If so, then the system instructs the patient to seekimmediate medical attention. Otherwise, the system software branches toother paths, such as an evaluation path. The algorithm that determinesif a serious medical condition exists, as well as the message that thepatient receives upon such a determination, may be customized by theentity that provides the service to its patients.

[0007] The current trend in medicine is to provide Internet-based toolsto improve communication between patients and medical providers, and toenable patients to become active participants in the management of theirhealth. Flowchart-based triage protocols are an excellent resource thatcan be provided to patients via an electronic network, such as theInternet. However, each medical provider has specific constraints thatit must impose on its patients. Thus, if flowchart-based triageprotocols are to become more widely used, they must have the ability tobe customized on many different levels and at a high degree ofgranularity. In this manner, the protocols can be tailored morespecifically to the availability of medical provider resources, as wellas the clinical practice patterns of the providers. Thus, the protocolscan become a business tool for the medical provider, as well as a usefulresource for the patient. The present invention fulfills such a need.

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] The foregoing summary, as well as the following detaileddescription of preferred embodiments of the invention, will be betterunderstood when read in conjunction with the appended drawings. For thepurpose of illustrating the invention, there is shown in the drawings anembodiment that is presently preferred. It should be understood,however, that the invention is not limited to the precise arrangementsand instrumentalities shown. In the drawings:

[0009]FIG. 1 shows an example of a generic flowchart of a triageprotocol in accordance with the present invention;

[0010]FIG. 2 shows an example of a default medical providercustomization user interface in accordance with the present invention;

[0011]FIG. 3 shows an internal customization table for storing settingsthat allow two different exit messages to be set for different timeperiods;

[0012]FIG. 4 shows the decision flowchart for the first time period inthe table of FIG. 3;

[0013]FIG. 5 shows the decision flowchart for the second time period inthe table of FIG. 3; and

[0014]FIG. 6 shows a table of privileges available to medical providersin accordance with a preferred embodiment of the present invention.

BRIEF SUMMARY OF THE INVENTION

[0015] A decision flowchart of a triage protocol is provided for amedical condition of a patient. The flowchart includes a plurality ofdecision blocks. Each decision block relates to one or more patientsymptoms and/or considerations. A plurality of exit points are providedin the flowchart. Each exit point is associated with a respectivedecision block. Each exit point is reached upon the presence or absenceof a symptom or consideration in the respective decision block. Eachexit point recommends an action to be taken by the patient. The exitpoints may be customized. More specifically, the recommended action atselected exit points may be individually selected from a plurality ofselectable actions. Thus, the decision flowchart may provide differentrecommended courses of action for a patient having the same symptomsand/or considerations based upon individual selections. The recommendedaction becomes an exit message for the respective exit point.

DETAILED DESCRIPTION OF THE INVENTION

[0016] Certain terminology is used herein for convenience only and isnot to be taken as a limitation on the present invention. In thedrawings, the same reference letters are employed for designating thesame elements throughout the several figures.

[0017] The present invention is described in the context of a softwareapplication called TalkToMeDoc that is part of a suite of applicationscalled MyDoc Online, which is being commercialized by MyDoc Online,Inc., Round Rock, Tex. (www.mydoconline.com). However, the scope of thepresent invention is not limited to this particular implementation ofthe invention. The present invention is described in the context of aplurality of distributed computers, all of which are linked together byan electronic network A-G, such as the Internet. The computers may beany type of computing device that allows a user to interact with a website via a web browser. For example, the computers may be a personalcomputers (PC) that run a Windows operating system. The computers mayalso be handheld, wireless devices. Patients, medical providers (e.g.,hospital, clinical facility), and medical practitioners each communicatevia a computer with a central host computer or a plurality ofdistributed host computers. The software application may be located atthe host in a thin client or application service provider (ASP)architecture, or the software application may reside on the local usercomputers.

[0018] Definitions

[0019] The following definitions are provided to promote understandingof the invention.

[0020] Complaint criteria—discrete complaints/symptoms defined in eachtriage protocol.

[0021] Exit point—a logical decision point, as defined by the particularprotocol, which may result in a departure from the protocol, and thedisplay of an Exit Message.

[0022] Exit Message—directive displayed to the patient at an exit point.In one preferred embodiment of the present invention, the predefineddefault set of possible exit messages, in decreasing degree of severity,is:

[0023] 1. Call 911

[0024] 2. Go to the Emergency Room

[0025] 3. Make an appointment with a physician within [4] hours *

[0026] 4. Make an appointment with a physician within [3] days *

[0027] 5. Make an appointment with a physician—no urgency

[0028] 6. Self-help information

[0029] Exit Message ID—unique identifier for exit messages 1,2,3,4,5,6above.

[0030] Exit Point ID—unique identifier designating an exit point in aprotocol.

[0031] Overview of Present Invention

[0032] A computer-implemented scheme provides a decision flowchart of atriage protocol for a medical condition of a patient. The flowchartincludes a plurality of decision blocks. Each decision block relates toone or more patient symptoms and/or considerations. In the method, aplurality of exit points are provided in the flowchart. Each exit pointis associated with a respective decision block. Each exit point isreached upon the presence or absence of a symptom or consideration inthe respective decision block. Each exit point recommends an action tobe taken by the patient.

[0033] An important feature of the present invention is the ability of amedical provider or medical facility to customize the exit points. Morespecifically, the recommended action at selected exit points may beindividually selected from a plurality of selectable actions. In thismanner, the decision flowchart may provide different recommended coursesof action for a patient having the same symptoms and/or considerationsbased upon individual selections. The recommended action becomes an exitmessage for the respective exit point.

[0034] The decision blocks will primarily relate to patient symptoms.However, some of the decision blocks may relate to one or more patientconsiderations such as a demographic (e.g., age, sex) or whether thepatient is currently taking certain medications.

[0035] Preferably, the patient's medical provider or medicalpractitioner makes the individual selections, as dictated by theprivileging authorities. However, a quasi-medical administrative entitymay also make the individual selections. After the selections are made,the decision flowchart may be used by patients who have been given theappropriate authorization to access the flowchart.

[0036] A plurality of different sets of exit messages can be setindependently of each other. For example, if a patient's medicalprovider has a plurality of different medical locations, then each setof exit messages may relate to one of the medical locations. Also, if apatient's medical provider has a plurality of medical practitioners,then each set of exit messages may relate to one of the medicalpractitioners. Each set of exit messages may be associated with adifferent time period of the day or a different range of dates.

[0037] At least some of the plurality of selectable actions for eachexit point include a customizable parameter. The customizable parameteris set by the medical provider or practitioner as part of thecustomization process. In the exit message example given above in theDefinitions section, the customizable parameter is the maximum number ofdays that the patient should wait to make an appointment.

[0038] Each of the plurality of selectable actions for each exit pointincludes a default action which provides a default exit message. Thedefault action is set in accordance with accepted medical procedures. Asa safety feature, the default action may be set to have the least degreeof severity of the selectable actions, thereby ensuring that selectingany of the other actions results in an exit message having a greaterdegree of severity than the exit message of the default action.

[0039] The individual selections may be made via a drop-down menu of auser interface, wherein each of the selectable actions is a selection inthe drop-down menu. Other selection methods are within the scope of thepresent invention.

[0040] Preferably, the decision blocks, connector symbols, and flowlinesymbols of the flowchart are successively displayed to a patient insequence and any decision blocks that occur after a patient has reachedan exit point are not displayed to the patient. In this manner, thepatient is not presented with additional decision blocks that may alterthe patient's perceived status of his or her symptom. Also, the userinterface is easier to navigate and visually interesting if the patientis only presented with decision blocks as they must be answered.Alternatively, the flowchart logic may execute in the background (notvisible to the patient), and the patient may only be presented with thequeries in the decision blocks, and the appropriate exit message basedon the logic in the flowchart.

[0041] Each recommended action may have a corresponding reporting actionthat indicates whether the results of the decision flowchart are to beforwarded to a storage location for subsequent retrieval by thepatient's medical provider or medical practitioner. During thecustomization, the reporting action is selected for each recommendedaction. Examples of reporting status may be: (i) send a report to amedical record; (ii) send an account of the interaction to the patient'smedical practitioner; or (iii) do not report.

[0042] In an alternative embodiment of the present invention, one of theselectable actions is to branch to a subsequent decision block in theflowchart, instead of exiting the flowchart at the exit point. Thisoption may be desirable if a particular medical provider or practitionerdoes not wish for the patient to exit the flowchart, even though thepatient meets the condition set forth in the decision block that pointsto the exit point. If provided, this option should be used sparingly,because the exit points are provided to communicate an exit message tothe patient, thereby terminating use of the decision flowchart.

DETAILED DESCRIPTION

[0043] The detailed description below presumes that the patient'sphysician is the medical practitioner who performs the customization.However, the scope of the invention includes embodiments wherein otherentities (but not including the patient) perform the customization.

[0044] The present invention provides a series of protocols that can beaccessed by patients through the TalkToMeDoc module. Each protocol hasthe following functionality:

[0045] 1. A discrete set of questions about the patient's perceivedhealth status.

[0046] 2. Answers supplied by direct input from the patient.

[0047] 3. A limited form of guidance proposed to the patient based uponthe patient's answers.

[0048] The physician can opt to not offer the module (in its entirety orby specific protocol) to his or her patients. If the physician offersthe module, he or she will have the ability to customize certainprotocol parameters determined by TalkToMeDoc.

[0049] 1. Protocols

[0050] a. Each protocol deals with a specific complaint/symptom pattern.

[0051] b. Each protocol contains a collection of discrete ComplaintCriteria.

[0052] i. The patient indicates which symptoms/indications of theComplaint Criteria are applicable.

[0053] ii. Based on the patient's response pattern at specified pointswithin a given protocol, the protocol offers either an additional levelof questions, or an Exit Point from the protocol with an Exit Message.

[0054] c. Each Exit Point within each protocol offered by TalkToMeDoccontains fixed Exit Messages, some with customizable parameters. Thecustomizable parameters are designated in brackets in the Exit Messagedefinition above.

[0055] d. Each Exit Point has an identifier, unique within the module(“exit point id”).

[0056] e. Each Exit Point has a default exit message assigned to it(“exit message” with “exit message id”).

[0057] 2. Physician Customization Capability

[0058] a. A physician may opt to disable individual protocols. Themodule defaults to offer all protocols.

[0059] b. A physician may alter the meaning of exit messages 3 and 4 bychanging the values of the parameters designated in brackets in the ExitMessage definition above.

[0060] c. A physician may alter the outcome of a protocol by changingthe exit message ID associated with an exit point (e.g., 3 may bechanged to 4).

[0061] i. Exit Message ID's can be changed only in a way to reflecthigher acuity or urgency of patient action, never a lesser acuityrelative to the default Exit Message id. This is controlled by use ofdropdown box options from which the physician can select.

[0062] ii. Changes can be made to apply by:

[0063] 1. Medical Location

[0064] 2. Physician

[0065] 3. Date range (to/from or indefinitely)

[0066] 4. Time of day (to/from: AM, PM, entire day)

[0067] d. When a protocol customization has been designated to be activefor a specifically defined time period, the protocol reverts to theTalkToMeDoc default at the end of that time period.

[0068] e. Complaint Criteria are not subject to customization.

[0069] f. Exit Points are not subject to customization.

[0070] 3. Privileging

[0071] a. Only a physician or physician-delegate may customize protocolelements as delineated above.

[0072] b. All protocols default to “unlock.” Locking a protocol preventsany user at a lower privileging level than the locking user to customizeany element of a protocol.

[0073] i. The Medical Organization Manager (MOM) may lock some or all ofthe protocols.

[0074] ii. The Medical Location Manager (MLM) may lock some or all ofthe protocols in use at that location.

[0075] iii. The hierarchy of privileging is as follows: MO ML DoctorDate Range (to/from) Time Range (to/from) protocol Exit Point ID ExitMessage ID (MO=medical organization, ML=medical location)

[0076] Privileging Examples:

[0077] a. MO can lock protocol system-wide, either all specialties orspecialty-specific.

[0078] b. MO can lock protocols into place at certain locations, andleave the same protocols unlocked at other locations.

[0079] c. Protocols can be “unlocked” for all physicians, enabling themto edit protocols individually.

[0080] 4. Logic of the Protocol Edit Capability

[0081] a. Physician selects from a listing of protocols.

[0082] b. Physician is presented with columns of Complaint Criteria andthe associated Exit Point and Exit Point Messages.

[0083] c. Physician may edit the Exit Point Message ID's from a dropdown box that offers only more cautious messages.

[0084] d. Physician is then able to assign time and date rangesassociated with the customized protocol.

[0085] 6. Tracking and Reporting

[0086] a. Certain features and activities within the protocol arerecorded in TalkToMeDoc for documentation and auditing purposes. Asdescribed above, a reporting action may be selected for each recommendedaction. Examples of reporting status include:

[0087] (i) Send a report to a medical record.

[0088] (ii) Send an account of the interaction to the patient's medicalpractitioner.

[0089] (iii) Do not report.

[0090] b. Reports to the provider are based on privileging and patientpermission.

[0091] c. Usage tracking applies to all patient uses of the flowchart.Generic usage statistics are gathered.

[0092] In an alternative reporting scheme, the reporting status isrelated to the severity of the exit message. For example, if the exitmessage is an emergency type message, then the reporting status may beset to a default option to send an account of the interaction to thephysician. If the exit message is a message instructing the patient tomake an appointment with the physician, then the reporting status may beset to a default option to not send an account of the interaction to thephysician. The scope of the present invention includes an alternativeembodiment wherein the default options may be changed by the physician.The scope of the present invention also includes an alternativeembodiment wherein the patient may selectively turn off the reportingfunction.

[0093] In an alternative embodiment of the present invention, the exitpoints are customized. One type of customization is to mark an exitpoint to branch to a subsequent decision block in the flowchart, insteadof exiting the flowchart at the exit point. As discussed above, thisoption may be desirable if a particular medical provider or practitionerdoes not wish for the patient to exit the flowchart, even though thepatient meets the condition set forth in the decision block that pointsto the exit point. Consider, for example, a decision block which asksthe patient, “Is your skin flush?” and which has an exit point if thepatient answers affirmatively. A particular physician in a particulartype of practice may not believe that this condition is sufficient towarrant exiting the protocol. Accordingly, the physician may wish tomark this exit point to be skipped. This may be performed either via anadditional drop-down menu item, or by providing a selection to thephysician to skip the exit point. As noted above, this option should beused sparingly because the exit points are normally provided tocommunicate an important exit message to the patient, therebyterminating use of the decision flowchart.

[0094]FIG. 1 shows an example of a generic flowchart of a triageprotocol in accordance with the present invention. The flowchartillustrates a plurality of exit points having exit point ID's (EP #1through EP #5), and a plurality of exit messages having exit messageID's (EM #1 through EM #1 through EM #5). If the patient meets none ofthe complaint criteria, then the patient is provided with self-helpinstructions.

[0095] The flowchart may have more complex branching than the simple,linear flowchart shown in FIG. 1 as long as there are a plurality ofexit points, at least some of which have customizable recommendedactions (i.e., customizable exit messages). Some exit points may not becustomizable. For example, a certain condition may warrant emergencytreatment, and the physician may not be offered the option to change theexit message for that condition.

[0096] If the patient is presented with the decision flowchart ingraphical form, the complaint criteria process symbol may providebackground information to the patient to assist the patient inresponding to the query presented in the subsequent decision symbol.Alternatively, if the query is short and simple, and can be fullypresented within the decision symbol, then there may be no need forpresenting the complaint criteria process symbol.

[0097] As discussed above, the patient may also be presented with thequeries and any background information in a less graphical format, suchas in a conventional questionnaire. In this embodiment, the logic of thedecision flowchart determines the order of presentation of thebackground information and questions, and the default and customizedrecommended actions at the exit points determines the appropriate exitmessage to present to the patient.

[0098]FIG. 2 shows an example of a default medical providercustomization user interface. In this example, for each exit message, adrop-down menu appears allowing the provider to select one of threeoptions: (1) Call 911; (2) Go to emergency room; or (3) Call within 4hours. The provider may also choose a time frame in which the exitmessage is to appear, or a time frame in which the exit message is todiffer from a default exit message, depending upon how the database isconfigured. As described above, the customization may be as granular asdesired, allowing for customization based on time of day, date ranges,medical location, medical practitioner within a practice group, and thelike.

[0099] As discusssed above, the default exit message may only be changedto an exit message that is more cautious than the default exit message.That is, as a safety feature, the default action is set to have theleast degree of severity of the selectable actions, thereby ensuringthat selecting any of the other actions results in an exit messagehaving a greater degree of severity than the exit message of the defaultaction. However, the scope of the present invention may include anembodiment where the default exit message may be changed to an exitmessage that is less or more or cautious than the default exit message(i.e., a greater or lesser degree of severity). This two-way embodimentshould be made available only in limited circumstances, and to limitedentities.

[0100] FIGS. 3-5 show an example wherein provider, Dr. Jones, sets twodifferent exit messages for different times of the day. FIG. 3 shows theinternal customization table for storing the settings. FIG. 4 shows thedecision flowchart for the first time period. FIG. 5 shows the decisionflowchart for the second time period. In this example, between 8:00am-5:00 pm, a patient who does not meet criterion 1 or 2, but who doesmeet criteria 3 is instructed to call the physician within four hours.However, between 5:00 pm-8:00 am, the same patient is instructed to goto the emergency room. This example may be suitable for a physician whois available for patient consultation (either in person during officehours, or by telephone) from 8:00 am-9:00 pm (four hours past 5:00 pm),but who is unavailable for patient consultation from 9:00 pm-8:00 am.

[0101]FIG. 6 shows a table of privileges for the Medical LocationManager (MLM), Medical Organization Manager (MOM), and the Doctor(medical provider), in accordance with one embodiment of the presentinvention.

[0102] The present invention provides important advantages overconventional patient diagnosis schemes. For example, the scheme shown inFIG. 10a of U.S. Pat. No. 5,594,638 has only one exit point (blocks 486,488) which occurs after the patient has answered all of a set ofscreening questions. Individual medical providers or practitionerscannot customize the exit points in such a scheme.

[0103] The customizable exit messages of the present invention, inconjunction with the ability to control when different exit messages areprovided, allows the medical provider to accommodate and control patientvisit volume based on office capacity, office hours, staff and physicianavailability, as well as hourly, daily, weekly and seasonal peaks andvalleys. For example, exit points may be set at a higher threshold(allowing for more at-home treatment) for non-urgent conditions, afterhours, when a physician is unavailable for office visits. Exit pointsmay be set at a higher threshold for a physician with a full practice,whereas exit points may be set at a lower threshold for a physician witha new practice.

[0104] Furthermore, a physician may be more likely to use pre-packagedInternet-based patient management tools such as TalkToMeDoc when thephysician is given the ability to customize patient care for theparticular needs of his or her patients.

[0105] The present invention may be implemented with any combination ofhardware and software. If implemented as a computer-implementedapparatus, the present invention is implemented using means forperforming all of the steps and functions described above.

[0106] The present invention can be included in an article ofmanufacture (e.g., one or more computer program products) having, forinstance, computer useable media. The media has embodied therein, forinstance, computer readable program code means for providing andfacilitating the mechanisms of the present invention. The article ofmanufacture can be included as part of a computer system or soldseparately.

[0107] Changes can be made to the embodiments described above withoutdeparting from the broad inventive concept thereof. The presentinvention is thus not limited to the particular embodiments disclosed,but is intended to cover modifications within the spirit and scope ofthe present invention.

What is claimed is:
 1. A computer-implemented method of providing adecision flowchart of a triage protocol for a medical condition of apatient, the flowchart including a plurality of decision blocks, eachdecision block relating to one or more patient symptoms and/orconsiderations, the method comprising: (a) providing a plurality of exitpoints in the flowchart, each exit point being associated with arespective decision block, each exit point being reached upon thepresence or absence of a symptom or consideration in the respectivedecision block, each exit point recommending an action to be taken bythe patient; and (b) individually selecting the recommended action atselected exit points from a plurality of selectable actions, thedecision flowchart thereby providing different recommended courses ofaction for a patient having the same symptoms and/or considerationsbased upon individual selections, the recommended action being an exitmessage for the respective exit point.
 2. The method of claim 1 furthercomprising: (c) providing a plurality of different sets of exit messagesthat can be set independently of each other.
 3. The method of claim 2wherein the patient's medical provider has a plurality of differentmedical locations, each set of exit messages relating to one of themedical locations.
 4. The method of claim 2 wherein the patient'smedical provider has a plurality of medical practitioners, each set ofexit messages relating to one of the medical practitioners.
 5. Themethod of claim 2 wherein each set of exit messages is associated with adifferent time period of the day or a different range of dates.
 6. Themethod of claim 1 wherein the plurality of selectable actions for eachexit point includes a default action which provides a default exitmessage.
 7. The method of claim 6 wherein the default action has theleast degree of severity of the selectable actions, thereby ensuringthat selecting any of the other actions results in an exit messagehaving a greater degree of severity than the exit message of the defaultaction.
 8. The method of claim 1 wherein at least some of the pluralityof selectable actions for each exit point includes a customizableparameter, the method further comprising: (c) selecting a parameter foreach of the customizable parameters prior to step (b).
 9. The method ofclaim 1 wherein the patient's medical provider makes the individualselections.
 10. The method of claim 1 wherein the individual selectionsare made via a drop-down menu of a user interface, each of theselectable actions being a selection in the drop-down menu.
 11. Themethod of claim 1 wherein a patient consideration is a patientdemographic.
 12. The method of claim 1 wherein the decision blocks aresuccessively displayed in sequence and any decision blocks that occurafter a patient has reached an exit point are not displayed to thepatient.
 13. The method of claim 1 wherein each recommended action has acorresponding reporting action that indicates whether the results of thedecision flowchart are to be forwarded to a storage location forsubsequent retrieval, the method further comprising: (c) individuallyselecting the reporting action for each recommended action.
 14. Themethod of claim 1 wherein one of the selectable actions is to branch toa subsequent decision block in the flowchart, instead of exiting theflowchart at the exit point.
 15. An article of manufacture for providinga decision flowchart of a triage protocol for a medical condition of apatient, the flowchart including a plurality of decision blocks, eachdecision block relating to one or more patient symptoms and/orconsiderations, the article of manufacture comprising acomputer-readable medium holding computer-executable instructions forperforming a method comprising: (a) providing a plurality of exit pointsin the flowchart, each exit point being associated with a respectivedecision block, each exit point being reached upon the presence orabsence of a symptom or consideration in the respective decision block,each exit point recommending an action to be taken by the patient; and(b) individually selecting the recommended action at selected exitpoints from a plurality of selectable actions, the decision flowchartthereby providing different recommended courses of action for a patienthaving the same symptoms and/or considerations based upon individualselections, the recommended action being an exit message for therespective exit point.
 16. The article of manufacture of claim 15wherein the computer-executable instructions perform a method furthercomprising: (c) providing a plurality of different sets of exit messagesthat can be set independently of each other.
 17. The article ofmanufacture of claim 16 wherein the patient's medical provider has aplurality of different medical locations, each set of exit messagesrelating to one of the medical locations.
 18. The article of manufactureof claim 16 wherein the patient's medical provider has a plurality ofmedical practitioners, each set of exit messages relating to one of themedical practitioners.
 19. The article of manufacture of claim 16wherein each set of exit messages is associated with a different timeperiod of the day or a different range of dates.
 20. The article ofmanufacture of claim 15 wherein the plurality of selectable actions foreach exit point includes a default action which provides a default exitmessage.
 21. The article of manufacture of claim 20 wherein the defaultaction has the least degree of severity of the selectable actions,thereby ensuring that selecting any of the other actions results in anexit message having a greater degree of severity than the exit messageof the default action.
 22. The article of manufacture of claim 15wherein at least some of the plurality of selectable actions for eachexit point includes a customizable parameter, the computer-executableinstructions performing a method further comprising: (c) selecting aparameter for each of the customizable parameters prior to step (b). 23.The article of manufacture of claim 15 wherein the patient's medicalprovider makes the individual selections.
 24. The article of manufactureof claim 15 wherein the individual selections are made via a drop-downmenu of a user interface, each of the selectable actions being aselection in the drop-down menu.
 25. The article of manufacture of claim15 wherein a patient consideration is a patient demographic.
 26. Thearticle of manufacture of claim 15 wherein the decision blocks aresuccessively displayed in sequence and any decision blocks that occurafter a patient has reached an exit point are not displayed to thepatient.
 27. The article of manufacture of claim 15 wherein eachrecommended action has a corresponding reporting action that indicateswhether the results of the decision flowchart are to be forwarded to astorage location for subsequent retrieval, the computer-executableinstructions performing a method further comprising: (c) individuallyselecting the reporting action for each recommended action.
 28. Thearticle of manufacture of claim 15 wherein one of the selectable actionsis to branch to a subsequent decision block in the flowchart, instead ofexiting the flowchart at the exit point.